The Effects of Heterologous Immunization with Prime-Boost COVID-19 Vaccination against SARS-CoV-2

Tzu-Chuan Ho; Yi-Ming Arthur Chen; Hung-Pin Chan; Chin-Chuan Chang; Kuo-Pin Chuang; Che-Hsin Lee; Cheng-Hui Yuan; Yu-Chang Tyan; Ming-Hui Yang

doi:10.3390/vaccines9101163

The Effects of Heterologous Immunization with Prime-Boost COVID-19 Vaccination against SARS-CoV-2

Vaccines (Basel). 2021 Oct 11;9(10):1163. doi: 10.3390/vaccines9101163.

Authors

Tzu-Chuan Ho¹, Yi-Ming Arthur Chen^{2

3}, Hung-Pin Chan⁴, Chin-Chuan Chang^{5

6

7

8}, Kuo-Pin Chuang⁹, Che-Hsin Lee¹⁰, Cheng-Hui Yuan¹¹, Yu-Chang Tyan^{1

6

9

12

13

14

15

16}, Ming-Hui Yang^{17

18}

Affiliations

¹ Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
² Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City 242, Taiwan.
³ National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County 350, Taiwan.
⁴ Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
⁵ Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
⁶ School of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁷ Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁸ Department of Electrical Engineering, I-Shou University, Kaohsiung 840, Taiwan.
⁹ Graduate Institute of Animal Vaccine Technology, National Pingtung University of Science and Technology, Pingtung 900, Taiwan.
¹⁰ Department of Biological Science, National Sun Yat-sen University, Kaohsiung 804, Taiwan.
¹¹ Mass Spectrometry Laboratory, Department of Chemistry, National University of Singapore, Singapore 119077, Singapore.
¹² Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹³ Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804, Taiwan.
¹⁴ Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
¹⁵ Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹⁶ Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹⁷ Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
¹⁸ Center of General Education, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821, Taiwan.

Abstract

Coronavirus Disease 2019 (COVID-19) pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become the global challenge. Reaching global herd immunity will help end the COVID-19 pandemic. However, vaccine shortage and vaccine hesitancy are the obstacles to achieve global herd immunity against SARS-CoV-2. The current homologous vaccine regimen is experimentally switching to heterologous vaccination at several study sites. However, the reactogenicity of heterologous ChAdOx1-S and mRNA vaccination against SARS-CoV-2 is still unclear. We have conducted a systematic review to summarize the current findings on the safety and immunogenicity of this heterologous vaccination and elucidate their implications against SARS-CoV-2. This systematic review was conducted by the guidelines of PRISMA. Articles were searched from PubMed and other sources (MedRixv and Google scholar) starting from 1 January to 5 September 2021. The search term was heterologous ChAdOx1-S and BNT162b2 or mRNA-1273 vaccination. Our review found that participants with ChAdOx1/BNT162b2, ChAdOx1-S/mRNA-1273 or BNT162b2/ChAdOx1-S did not have the serious adverse events seen with homologous vaccination. Participants with the heterologous regimen (ChAdOx1/BNT162b2, ChAdOx1-S/mRNA-1273 or BNT162b2/ChAdOx1-S), compared with those with two doses of ChAdOx1-S, have shown a more robust immune responses against SARS-CoV-2, such as higher levels of responsive antibodies or increased numbers of spike-specific T-cells. Nevertheless, these immune responses were slightly diminished in the recipients of BNT162b2/ChAdOx1-S. Also, the safety study of heterologous ChAdOx1-S/mRNA vaccination was based on small populations. Further studies to enclose diverse categories, such as race/ethnicity or geography, may be necessary. Overall, the heterologous immunization with ChAdOX1-S and the mRNA vaccine may improve the vaccine shortage related slow pace of reaching herd immunity, especially using the heterologous immunization with ChAdOx1-S/BNT162b2.

Keywords: COVID-19; SARS-CoV-2; T-cell response; heterologous; vaccine safety.

Publication types

Review

Grants and funding

MOST 109-2221-E-037-001-MY3/Ministry of Science and Technology